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Third MMR Vaccine Dose Beneficial to Young Adults
Vaccine; 2018 Sep; McLean, Fiebelkorn, et al
Vaccination with a third dose of measles-mumps-rubella (MMR) vaccine resulted in a robust boosting of rubella neutralizing antibody response that remained elevated 1 year later, a recent study found. Therefore, young adults with low rubella titers are more likely to benefit from a third dose of MMR vaccine. Young adults aged 18–31 years with documented 2 doses of MMR vaccine received a third dose of MMR vaccine between July 2009 and October 2010. Rubella neutralizing antibody titers were assessed before, 1 month, and 1 year after receipt of a third dose of MMR vaccine. Researchers found:
- Among 679 participants, 1.8% had rubella antibody titers <10 U/ml, immediately before vaccination, approximately 15 years after receipt of a second dose of MMR vaccine.
- 1 month after receipt of a third dose of MMR vaccine, average titers were 4.5 times higher and >50% of participants had a 4-fold boost.
- Response was highest among those with titers <10 U/ml prior to vaccination (geometric mean titer ratio = 18.8; 92% seroconversion) and decreased with increasing pre-vaccination titers.
- Average titers declined 1 year post-vaccination but remained significantly higher than pre-vaccination levels.
McLean HQ, Fiebelkorn AP, Ogee-Nwankwo A, et al. Rubella virus neutralizing antibody response after a third dose of measles-mumps-rubella vaccine in young adults. Vaccine. 2018;36(38):5732-5737. doi:10.1016/j.vaccine.2018.08.010.
A 2-dose vaccination series is recommended for MMR vaccine, but recently a third dose has been recommended in mumps outbreaks and some other circumstances. Since MMR contains 3 different antigens, it makes sense to collect data on the response to each antigen in the vaccine. Looking at the rubella antibody response to a third MMR vaccine, 50% of patients had a 4-fold boost in antibodies, with a better response in those with lower pre-vaccination antibodies.—Sarah Rawstron, MB, BS, FAAP, FIDSA; Pediatric Residency Program Director, The Brooklyn Hospital Center, NY; Clinical Associate Professor, Icahn School of Medicine, Mount Sinai, NY.